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15 Sep 2017

Hennig T et al. J Nerv Ment Dis 2017; 205: 720-724

Previous research has demonstrated that adults with ADHD have reduced life satisfaction versus individuals without ADHD. This observation may be related to the challenges faced by patients with ADHD, e.g. increased rates of comorbidity versus the general population and poorer outcomes related to education, vocation and health status. Although it is well documented that ADHD correlates with reduced life satisfaction, it is unclear what mechanisms may explain this association. This study investigated the association between symptoms of ADHD and reduced life satisfaction, and assessed the mediating impact of social support and/or depressive symptoms.

The study consisted of predominantly adult participants (N=2517; age range 14–91 years) from the general German population; participants were chosen at random and visited at home following a random-route procedure of 258 sample locations in all 16 federal states of Germany (participation rate was 62.1%). Participants were assessed using the self-rated ADHS-E scale* and overall life satisfaction was determined using the self-rated SWLS.Social support was measured using the self-rated OSS-3 and depressive symptoms were assessed using a module from the PHQ-9.§ Correlation between ADHD symptoms and life satisfaction was controlled for demographic factors (gender, age, income) and common risk factors (not being in a relationship, being unemployed).

In line with previous studies, results from this study indicated that symptoms of ADHD negatively correlated with life satisfaction (r = -0.41), an effect that was statistically significant (p<0.01). Moreover, after demographic factors and common risk factors were controlled for, a reduction in life satisfaction continued to correlate with ADHD symptoms (r = -0.39; p<0.01). Life satisfaction was lower in participants with ADHD who were older (p<0.01), had less income (p<0.01), were not in a relationship (p<0.01) or were unemployed (p<0.01); however, gender (p=0.60) was not a significant predictor of life satisfaction. In the controlled model, demographic and risk factors explained 14% of the variance in life satisfaction.

Both lack of social support and depressive symptoms mediated the association between ADHD symptoms and a reduction in life satisfaction (p<0.01). Lack of social support and depressive symptoms mediated 20% and 38%, respectively, of this association in the unrestricted model, and 23% and 44%, respectively, in the controlled model.

However, as this study was based on cross-sectional data, the direction of the effect cannot be fully verified because the authors could not confirm if ADHD symptoms preceded a lack of social support and/or depressive symptoms, or vice versa. Therefore, although the models used in this study were grounded in theory, these findings need to be corroborated in longitudinal studies.

The authors concluded that symptoms of ADHD are associated with impairments to overall life satisfaction beyond common risk factors, with a lack of social support and depressive symptoms relevant mediating factors. The authors suggested that improving social relationships and attenuating depressive symptoms (e.g. via cognitive behavioural therapy) may lead to an increase in overall life satisfaction in adults with ADHD symptoms.

Read more about the correlation between the symptoms of ADHD and life satisfaction here

 

*The ADHD Screening for Adults (ADHS-E) scale has five subscales (attention control, emotion and affect, stress tolerance, impulse control/disinhibition, and fidgetiness and hyperactivity), each rated on a 4-point Likert-type scale

The Satisfaction with Life Scale (SWLS) has demonstrated good internal consistency and validity, and consists of five items (e.g. “In most ways my life is close to ideal” and “The conditions of my life are excellent”) that are rated on a 6-point Likert-type scale

The Oslo Social Support Scale (OSS-3) consists of three items (number of people to count on, other peoples’ interest, help from neighbours), each rated on a 4- or 5-point Likert-type scale

§The Patient Health Questionnaire (PHQ-9) contains nine items (e.g. “little interest or pleasure in doing things”, “feeling, down, depressed or hopeless”), and enables participants to rate how frequently they have been affected by these items in the last 2 weeks on a 4-point Likert-type scale

Hennig T, Koglin U, Schmidt S, et al. Attention-deficit/hyperactivity disorder symptoms and life satisfaction in a representative adolescent and adult sample. J Nerv Ment Dis 2017; 205: 720-724.

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